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Hemorrhagic thoracic schwannoma presenting with intradural hematoma and acute paraplegia after spinal manipulation therapy

Alia Hdeib, MD,1,2 C. Rory Goodwin, MD, Ph.D.,1 Daniel Sciubba, MD,1 Ali Bydon, MD,1 Jean-Paul Wolinsky, MD,1 Timothy Witham, MD,1 Ziya L. Gokaslan, MD1,3

1Johns Hopkins University School of Medicine, Department of Neurological Surgery, Baltimore, MD 2University Hospitals Case Medical Center, Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH 3The Warren Alpert Medical School of Brown University, Department of Neurosurgery, Providence, RI

Abstract 

Hemorrhagic conversion of spinal schwannomas represents a rare occurrence; also rare is the development of a spinal intradural hematoma after spinal manipulation therapy. We report a unique presentation of paraplegia in a patient who underwent spinal manipulation therapy and was found to have a hemorrhagic thoracic schwannoma at time of surgery in the setting of anti-platelet therapy use. In patients with spinal schwannomas, tumor hemorrhage is a rare occasion, which can be considered in the setting of additive effects of spinal manipulation therapy and antiplatelet therapy.

keywords: 
Thoracic schwannoma, hemorrhagic schwannoma, spinal schwannoma, intradural spinal hemorrhage
Volume 10 Article 42
doi: 
10.14444/3042